STACY LANDON CENTENO Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****53

License Status

NOT RENEWED

Business

First Name

STACY LANDON

Last Name

CENTENO

Business Name

STACY LANDON CENTENO

Original Issue Date

06/07/2016

Effective Date

03/01/2018

Expiration Date

09/30/2020

City

GLEN ELLYN

State

Zip

60137

County

DUPAGE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021